Individual provider Active NPI

Aimee Mahoney, M.S, CCC-SLP

  • Speech-Language Pathologist
  • Palm Coast, FL
National Provider Identifier
1245530765
Registry record updated Nov 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA11599 Issued in FL
Practice address
4875 Palm Coast Pkwy NW
Suite 2
Palm Coast, FL 32137-3670
Phone
(386) 446-9935
Fax
(386) 446-7777
NPI assigned
Nov 1, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SA11599 FL Primary

Addresses

Primary practice location

4875 Palm Coast Pkwy NW
Suite 2
Palm Coast, FL 32137-3670

Mailing address

64 Rollins LN
Palm Coast, FL 32164-6947
Phone (352) 359-1725

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
SA11599FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
A Place to Grow Pediatric Therapy Speech-Language Pathologist PastSince Jul 24, 2022 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1288569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415059200000",
    "number": "1245530765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 ROLLINS LN",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321646947",
            "telephone_number": "352-359-1725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4875 PALM COAST PKWY NW",
            "address_2": "SUITE 2",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321373670",
            "telephone_number": "386-446-9935",
            "fax_number": "386-446-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHONEY",
        "first_name": "AIMEE",
        "credential": "M.S, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-01",
        "last_updated": "2014-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA11599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Coast, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.